Posterior urethral valve with unilateral vesicoureteral reflux and patent urachus: A rare combination of urinary tract anomaliess

Abstract

Posterior urethral valve (PUV) is a common cause of lower urinary tract obstruction in male infants with an incidence of 1:5000-8000. PUV continues to be a significant cause of morbidity and ongoing renal damage in infants and children. It can coexist with vesicoureteral reflux (VUR) in about 50% of cases and also with patent urachus in about one-third of cases. It is a case of a 22-day-old full-term male child who presented with poor urinary stream and progressive abdominal distension of 5-day duration as well as leakage of clear fluid from umbilicus of 1-day duration. Abdominopelvic ultrasonography showed bilateral hydronephrosis. Micturating cystourethrogram also showed features of bladder outlet obstruction and PUV. In addition, a grade V left VUR and a fistulous tract between the dome of the urinary bladder and the umbilicus, which was consistent with a patent urachus was demonstrated. In conclusion, this case demonstrates a rare combination of congenital urinary tract anomalies involving PUV, left VUR and patent urachus.

Late diagnosis of posterior urethral valves: a case report and the literature review

“…Diagnosis of UTI in the boy was the cause of further diagnostics including VCM, which revealed the presence of the unilateral 3 rd -grade of VUR and dilated urethra. VUR as PUV complication is present in about half of all diagnosed cases and mostly, like in our patient, occurs unilaterally [18]. Dilated urethra might suggest PUV although performed in our patient urodynamic studies did not suggest the presence of obstruction but overactivity and reduction of bladder capacity.…”

Posterior urethral valves and urachal cyst: an unusual combination

“…PUV are abnormal congenital obstructing membranes located within the posterior male urethra. The embryology of PUV is not completely understood; it has been hypothesised that presence of PUV is correlated with an abnormal insertion of the mesonephric ducts into the fetal cloaca before the eighth week of gestation or to the persistence of the cloacal membrane 9. Presence of PUV is the most common congenital cause of male urethral obstruction with an estimated incidence of 1/5000–1/8000 male births 1.…”

“…The urachus or median umbilical ligament is an embryonic structure arising from the allantois 2. It is a fibrous cord located in the middle of peritoneum and transversalis fascia extending from umbilicus to the dome of the bladder 9. It is composed of three layers: modified transitional epithelium, fibroconnective tissue and a layer of smooth muscle continuous with the detrusor 10.…”

Učestalost hidronefroze kod djece i adolescenata hospitalizovanih na Klinici za dječje bolesti Banja Luka

“…Opstrukcija koja dovodi do razvoja hidronefroze može da bude u nivou gornjeg ili donjeg dijela urotrakta. Podaci iz literature pokazuju da je kongenitalna stenoza P-U segmenta najčešća opstruktivna mana gornjeg urotrakta [4,5,11], a da je valvula zadnje uretre najčešća opstruktivna mana donjeg urotrakta sa incidencom od 1:5000-8000 kod dječaka [12]. Kod 54,4% naših ispitanika opstrukcija je bila u nivou P-U segmenta, pri čemu je kod 14% dokazano da se radi o kongenitalnoj stenozi, a stenotični prsten obično je dug nekoliko milimetara.…”